弥散加权成像-阿尔伯塔卒中项目早期CT评分对急性前循环脑梗死患者早期神经功能恶化的预测价值

The value of diffusion weighted imaging-Alberta stroke project early CT score in predicting early neurological deterioration in patients with acute anterior circulation cerebral infarction

目的探讨弥散加权成像-阿尔伯塔卒中项目早期CT评分(DWI-ASPECTS)对急性前循环脑梗死患者早期神经功能恶化(END)的预测价值。方法回顾性分析2014年10月1日-2016年6月30日于我院神经内科收治的急性前循环脑梗死患者的相关资料,依据是否发生END分为END组和非END组,分析比较两组间临床变量之间的差异,采用受试者工作特征(ROC)曲线评估DWI-ASPECTS评分对急性前循环脑梗死患者END的预测价值。结果END组DWI-ASPECTS评分显著低于非END组(P<0.001)。Logistic回归分析结果显示,DWI-ASPECTS评分(OR=0.646,95%CI 0.466~0.895,P=0.009)低密度胆固醇LDL-C(OR=1.526,95%CI 1.006~2.316,P=0.047)是END的独立危险因素。ROC曲线分析提示DWI-ASPECTS评分以7分为截点时,曲线下面积为0.769(95%CI=0.715~0.818),灵敏度61.54%,特异度88.04%。结论DWI-ASPECTS评分对急性前循环脑梗死患者END有较好的预测价值,值得大样本研究进一步验证。

Objective To explore the value of diffusion weighted imaging-Alberta stroke project early CT score(DWI-ASPECTS)in predicting early neurological deterioration(END)in the patients with acute anterior circulation cerebral infarction.Methods The data patients with acute anterior circulation cerebral infarction treated in the department of neurology of our hospital from October 012014 to June 302016 were retrospectively analyzed.According to the occurrence of END.The patients were divided into END group and non-END group.The differences of clinical variables between the two groups were analyzed and compared.ROC curve was used to evaluate the predictive value of DWI-ASPECTS score in the patients with acute anterior circulation cerebral infarction.Results The DWI-ASPECTS score of END group was significantly lower than that of non-END group(P<0.001).The DWI-ASPECTS(95%CI 0.466~0.8,95%CI 0.466~0.895%score 0.009)and the LDL-C(95%CI 1.006~2.316 score 0.047)were independent risk factors for END.ROC curve shows that when the DWI-ASPECTS is 7 as the cut-off point.The area under the curve is 0.769(95%CI 0.715~0.818),the sensitivity is 61.54%and the specificity is 88.04%.Conclusion DWI-ASPECTS has a good predictive value in the patients with acute anterior circulation cerebral infarction.Which should be further verified by a large sample study.